Happy New Year! Our first newsletter of 2011 spotlights exciting developments in an area of great potential for MR-guided focused ultrasound - pancreatic tumor treatment.
As you will read, clinicians in Europe recently treated patients with focused ultrasound to relieve pain associated with pancreatic tumors.
At St. Mary's Hospital in London, Wladyslaw Gedroyc, M.D. successfully treated an 89-year-old woman with a large, yet benign pancreatic tumor.
At Sapienza University of Rome, Alessandro Napoli, M.D., Ph.D. and his colleagues achieved a major clinical milestone by treating the first patient with primary pancreatic cancer as part of a Phase 1 clinical trial.
In addition to the progress being made in the ablative uses of MR-guided focused ultrasound, this month's featured researcher, Joo Ha Hwang, M.D., Ph.D. of the University of Washington, reports the technology holds great potential in mediating drug delivery to pancreatic tumors. Hwang and his colleagues are now conducting preclinical research. If results remain positive, they could launch clinical trials within a few years.
While these developments are indeed encouraging, it is important to note that many challenges must be surmounted before of MR-guided focused ultrasound attains regulatory approval and widespread adoption as a treatment for pancreatic tumors and cancers.
Regarding ablative procedures, Prof. Gedroyc points out, "We have a long way to go before FUS for pancreas is commonly possible and accepted. For example, we need better technology to avoid gas filled gut structures which can also compensate for movement due to breathing, etc. It will be a while before this is forthcoming."
On a positive note, he adds, "The outcome in this disease is so dismal, it may be possible to start trials more quickly than in an area where there is a well defined treatment already in place."
MR-guided focused ultrasound could have "huge impact" on pancreatic cancer drug delivery
The hardest part of his job, says Joo Ha Hwang, M.D., Ph.D., is informing patients that they have pancreatic cancer.
Hwang, a leading researcher in focused ultrasound and gastroenterologist at the University of Washington in Seattle, is troubled by the lack of effective treatments for this deadly disease. "For decades, we've been treating pancreatic cancer and coming up with one new drug regimen after another. Yet, nothing has made a dent in improving patient survival," he notes.
Preclinical studies using MR-guided focused ultrasound for targeted drug delivery have achieved promising results, and Hwang believes clinical trials could begin within the next two years. "The potential impact of focused ultrasound could be huge," he says. "It could completely change the paradigm for treating patients with pancreatic cancer."
Doris McArdle (seated center) was a guest of honor at the 2010 David and Diane Heller Dinner at the RSNA meeting in Chicago. She was joined by her daughter, Sharon Duffy (seated on the left), Rita Havey (seated on the right) and (standing from left to right) by her son-in-law John Duffy, her son George McArdle, Jr. and her physician Dr. Robert Havey.
"What a difference a year makes!" exclaimed Doris McArdle and her daughter, Sharon Duffy, in a recent New Year's greeting.
The recipients of that message - David Heller, Neal Kassell, M.D. and Wladyslaw Gedroyc, M.D. - made a difference that McArdle will never forget. In November 2010, the indomitable 89-year-old McArdle boarded a trans-Atlantic flight from Chicago to London. There, she successfully underwent a non-invasive MR-guided focused ultrasound procedure to relieve the acute pain and discomfort caused by a large benign tumor in her pancreas.
According to Duffy, "The hardest part of the whole undertaking was the travel to and from London and dealing with jet lag. The procedure itself was very successful! We would heartily recommend others to consider focused ultrasound. I think the greatest testimonial is that my mother would go to all the way to London and do the procedure again!"
Italian team performs first clinical pancreatic cancer treatment with MR-guided focused ultrasound
Site update: Sapienza University of Rome, School of Medicine, Italy
Alessandro Napoli, M.D., Ph.D., Head of MR-guided FUS Unit.
"To our knowledge, we have performed the very first clinical treatment of pancreatic cancer with MR-guided focused ultrasound and demonstrated that the technique is both safe and feasible," reports Alessandro Napoli, M.D., Ph.D. of the Department of Radiological Sciences at Sapienza University of Rome.
Carlo Catalano, M.D., Vice Chair and Head of CT and MR Sections.
Napoli and his academic team - Carlo Catalano, M.D. and Roberto Passariello, M.D. - performed the treatment in October 2010 to provide pain palliation for a patient with primary pancreatic cancer. They are currently enrolling other patients with Stage 3 pancreatic cancer, typically with vascular engagement and no operability criteria. The Phase 1 study is expected to enroll 12 patients over an 18-month period.
The team is also enrolling patients under a treat and resect protocol for both prostate and breast cancer. "The prostate protocol has never been done before," Napoli says. "It is a Phase I, single-center study and will enroll 13 patients."
Roberto Passariello, M.D., Chairman, Department of Radiological Sciences.
The breast cancer study is a Phase II multicenter trial that could ultimately treat 200 patients during a 15-year span. Sapienza's focused ultrasound center will enroll as many patients as possible.
Since installing an ExAblate 2100 system in May 2010, Napoli and his team have treated 12 patients with malignant bone tumors. "We have treated six patients with pain, and six who are painless, in order to achieve tumor control," he adds.
To date, the center's most requested treatment is for uterine fibroids, and Napoli and his colleagues have treated 15 patients with 19 fibroids.
Looking ahead, the Sapienza focused ultrasound team is planning to treat both primary and secondary liver lesions. As Napoli notes, "Due to the natural inflow of patients to our hospital, I anticipate that liver, prostate and pancreas will be the most treated lesions at our center."
Further information about MR-guided focused ultrasound treatments and clinical trials at Sapienza University of Rome is available from Dr. Napoli at ().
Keyvan Farahani, Ph.D., of the Cancer Imaging Program at the National Cancer Institute (NCI) reports that funding is available through four research initiatives in image-guided cancer interventions. For further information email Dr. Farahani at .
Fibroid Relief to kick off 2011 with patient education event in Charlottesville
The FUS Foundation's patient-support organization, Fibroid Relief, is kicking off 2011 with a free educational event in Charlottesville, Virginia on February 3. The event will be the first held in conjunction with the Focused Ultrasound Center of Excellence at the University of Virginia.
According to Tina Krall, executive director of Fibroid Relief, confirmed speakers include Alan Matsumoto, M.D. (Focused Ultrasound and Uterine Fibroid Embolization); Elisa Trowbridge, M.D. (Robotic Myomectomy); Bruce Bateman, M.D. (Gynecology and Fertility); Annette Owen, M.D. (Sexual Health); Cindy Janechild, R.N. (Holistic Medicine) and three uterine fibroid patients, one of whom was successfully treated with MR-guided focused ultrasound at UVA.
"We're excited to bring our important message to patients in Central Virginia and encourage everyone to follow us on the Fibroid Relief website and on our Facebook page ," Krall says.
4th Therapeutic Ultrasound School set for March 14-18 in France
The FUS Foundation is one of the sponsors of the 4th Therapeutic Ultrasound School being held in Les Houches, France. Successor to the hugely successful schools in Oxford and Corsica, the program will explore the rapidly emerging field of therapeutic ultrasound. Topics will range from an introduction to the physics and biophysics necessary for understanding these techniques to clinical applications. Each topic will be covered by an invited speaker who is a world authority in the field.